End-Tidal Hypocapnia Under Anesthesia Predicts Postoperative Delirium

Frontiers in Neurology
W Alan C MutchEric Jacobsohn

Abstract

Background: Postoperative delirium (POD) might be associated with anesthetic management, but research has focused on choice or dosage of anesthetic drugs. We examined potential contributions of intraoperative ventilatory and hemodynamic management to POD. Methods: This was a sub-study of the ENGAGES-Canada trial (NCT02692300) involving non-cardiac surgery patients enrolled in Winnipeg, Canada. Patients received preoperative psychiatric and cognitive assessments, and intraoperatively underwent high-fidelity data collection of blood pressure, end-tidal respiratory gases and anesthetic agent concentration. POD was assessed by peak and mean POD scores using the Confusion Assessment Method-Severity (CAM-S) tool. Bivariate and multiple linear regression models were constructed controlling for age, psychiatric illness, and cognitive dysfunction in the examination of deviations in intraoperative end-tidal carbon dioxide (areas over (AOC) and under the curve (AUC)) on POD severity scores. Results: A total of 101 subjects [69 (6) years of age] were studied; 89 had comprehensive intraoperative hemodynamic and end-tidal gas measurements (data recorded at 1 Hz). The incidence of POD was 11.9% (12/101). Age, cognitive dysfunction, anxiety, d...Continue Reading

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Citations

Dec 12, 2019·The Journal of Physiology·James DuffinJoseph A Fisher
Dec 14, 2019·Medizinische Klinik, Intensivmedizin und Notfallmedizin·Cynthia Olotu
Aug 30, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Alan C MutchRenée M El-Gabalawy
Mar 7, 2020·Critical Care : the Official Journal of the Critical Care Forum·W Alan C MutchM Ruth Graham
Aug 29, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Richard E Moon
Jul 24, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Alan C MutchM Ruth Graham
Oct 3, 2020·Anaesthesia Critical Care & Pain Medicine·Vanessa LalmiJean-Francois Payen
Jun 10, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Alan C Mutch, James Duffin
Aug 22, 2021·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Benjamin K I HelfandRichard N Jones
May 4, 2021·Minerva anestesiologica·Cynthia Olotu

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Clinical Trials Mentioned

NCT02692300

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